Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Glen Neal Lilly II, PA-C

Individual provider Physician Assistant · NPI 1275935934

Mr. Glen Neal Lilly II, PA-C is a Physician Assistant in Hollywood, Maryland. Qualified in 2014, 12 years ago. Practices with Medstar Medical Group - Southern Maryland LLC, a 237-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Maryland and South Carolina.

Years since qualifying
12
Licensed in
MD, SC
In the registry since
2014
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

24035 Three Notch Rd
Hollywood, MD 20636-4871
Phone: (301) 373-7100
Fax: (301) 373-6100
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 10 Saint Patricks Dr, Waldorf, MD 20603-4572 — (301) 705-7870
  • 4301 Dick Pond Rd, Myrtle Beach, SC 29588-6807 — (843) 652-8100

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence C0009583 (MD)
Physician Assistant Taxonomy 363A00000X · Licence TL2189 (SC)

Record details

NPI number1275935934
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 24, 2014
Last updated in NPPESMarch 19, 2026
Certification dateMarch 19, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Medstar Medical Group - Southern Maryland Llc — 237 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Hollywood